This case report illustrates the rationale, technique, and the excellent clinical outcomes achieved in a complex patient with extra-articular deformity using an ABCANS-assisted TKA.
This case report illustrates the rationale, technique, and the excellent clinical outcomes achieved in a complex patient with extra-articular deformity using an ABCANS-assisted TKA.The utilization of the direct anterior approach (DAA) for total hip arthroplasty (THA) continues to markedly increase. Despite proposed advantages, there are limited data regarding outcomes of staged bilateral THA via 2 different approaches in the same patient. The purpose of this study was to elucidate patient perspective on the THA approach in a crossover cohort of patients who underwent consecutive THAs via the posterolateral approach (PLA) followed by a contralateral DAA.
A retrospective chart review and telephone interview were performed on 37 patients who underwent both THA approaches by a single surgeon from 2009 to 2019. Perioperative outcomes, complications/reoperations, and the patient-preferred approach were collected. The mean clinical follow-up was 105 and 44 months after PLA and DAA, respectively.
After https://www.selleckchem.com/products/ars-853.html , patients demonstrated lower postoperative day 1 visual analog scale pain scores (1.8 vs 2.9, = .016) and ambulation (239 feet vs 31 feet, &lt; .001). The length of stay was significantly less (&lt; .001) for the DAA (1.9 days) compared with the PLA (3.1 days). #link# There were no major complications or reoperations in either cohort. Most patients (26/37, 70%) preferred the DAA and stated that it was easier to recover from (30/37, 81%).
In the same patient direct comparison, the DAA for THA may lead to less pain and improved ambulation in the early postoperative period. Furthermore, most patients prefer the DAA and believe it is easier to recover from than the PLA.
In the same patient direct comparison, the DAA for THA may lead to less pain and improved ambulation in the early postoperative period. Furthermore, most patients prefer the DAA and believe it is easier to recover from than the PLA.Leg length discrepancy is not an uncommon result of total hip arthroplasty and a major cause of patient dissatisfaction. Spinopelvic obliquity is a less-recognized cause of limb length differences in patients undergoing total hip arthroplasty. The robotic arm has recently been introduced to enhance implant positioning during surgery and to achieve more predictable leg length and offset goals. In this article, we illustrate the case of a patient who presented with a leg length discrepancy associated with significant spinopelvic obliquity. We show the use of the robotic arm total hip application to improve her pelvic obliquity and limb length discrepancy. This approach helped with the patient's symptoms and gait as well as her radiographic pelvic alignment.Total hip arthroplasty (THA) has demonstrated excellent results regardless of the surgical approach. However, the approach used may be a factor in final positioning of implants. We hypothesized that the direct anterior approach (DAA) with fluoroscopy would be associated with more anatomic implant positioning than the posterior approach (PA).
A retrospective review of 200 patients was performed. One hundred patients underwent THA utilizing the PA, and 100 patients, with the DAA. All patients had an anterior-posterior pelvis radiograph preoperatively and postoperatively with a magnification marker present to standardize each radiograph. Exclusion criteria included contralateral THA or any pelvic or femoral deformity.
Preoperative radiographs demonstrated identical cohorts with respect to leg length, femoral offset, and total offset. Postoperatively, the DAA achieved more accurate anatomic restoration of leg length (1.6 mm vs 5.5 mm; &lt; .0001), femoral offset (4.8 mm vs 9.3 mm; &lt; .0001), and totimplant positioning was performed under fluoroscopic guidance, whereas the PA was not. (2) The PA disrupts the posterior capsule and external rotators, and therefore, increased offset or leg length may be necessary to achieve comparable hip stability with the DAA.Total hip arthroplasty (THA) is an effective operation for patients with hip osteoarthritis; however, patients with hip dysplasia present a particular challenge. Our novel study examined the effect of robot-assisted THA in patients with hip dysplasia.
We retrospectively reviewed patients with developmental dysplasia of the hip undergoing primary THA using robotic arm assistance at 2 institutions from January 2010 to January 2017. Patients undergoing revision arthroplasty were excluded. Preoperatively, all patients underwent a computed tomography scan so that 3-dimensional templating could be performed. Hip range of motion (ROM) and clinical leg length discrepancy were recorded preoperatively. Two independent observers calculated Crowe and Hartofilakidis grades for each operative hip. At the final follow-up, hip ROM, postoperative complications, and modified Harris Hip scores were obtained.
Seventy-nine patients underwent THA because of degenerative joint disease in the setting of developmental dysplasia of the hip. There were 56 females and 23 males with a mean age of 45 years (range 26-64 years). We found that components were placed according to the preoperative plan, that there was an improvement in the modified Harris hip score from 29 to 86 (&lt; .001), an improvement in the hip ROM (flexion improvement from 66° to 91°, &lt; .0001), and a correction of leg length discrepancy (17.1 vs 4 mm, &lt; .0002). There were no complications during the short-term interim follow-up (mean 3.1 years).
Robot-assisted THA can be a useful method to ensure adequate component positioning and excellent outcomes in patients with hip dysplasia.
Level III, Retrospective.
Level III, Retrospective.The construction of industrial projects involves fabricating and installing massive quantities of pipelines. The design data of pipelines is complex, usually unique for each project and not easily available to researchers and the public for confidentiality reasons. As a result, an industrial pipelines data generator able to realistically simulate pipelines structures will lessen the dependence on real-life data. This article describes an industrial pipelines data generator that was developed using topological and physical properties of pipelines from real industrial projects. This generator can simulate the properties (the type of component, length, diameter, running direction, and the connectivity relationships between components) of real industrial pipelines. Its application in construction engineering and management research, more specifically in the experimental analysis of an optimization algorithm, was described by the authors in previous work [1]. The data generator can be used to develop benchmark problem instances for optimization problems and for simulation studies of construction operations in industrial projects.